March 10th, 2011
Podcast 115: Talking about the real-world use of dabigatran with Drs. Elaine Hylek and Samuel Goldhaber
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Clinical Conversations, in a collaboration with CardioExchange, has interviewed two expert working clinicians on how best to use dabigatran — a drug poised to supplant warfarin in the prevention of stroke and systemic embolism in patients with atrial fibrillation.
The wide ranging discussion with Drs. Elaine Hylek and Samuel Goldhaber includes sections on who should be on this new anticoagulant, management of the drug around surgical procedures, and promoting adherence, among others.
CardioExchange (http://www.cardioexchange.org/) is an experiment in clinical community-building, sharing information from both Journal Watch and the New England Journal of Medicine. If you’re interested in matters of the heart you should really give it a look.
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One Response to “Podcast 115: Talking about the real-world use of dabigatran with Drs. Elaine Hylek and Samuel Goldhaber”
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I believe the presenters were not completely fair and balanced in their presentation of the facts.
Dr. Goldhaber repeatedly emphasized the 34% reduction in hemorrhagic strokes but never mentioned that the absolute reduction in strokes (ischemic and hemorrhagic) was actually 0.6% with a NNT of 167. The absolute decrease in intracranial bleeding per year was 0.28% with the NNH with warfarin of 357.
Neither presenter mentioned that the Re-Ly was an open label study and both chose to ignore the higher trends for increased MIs and drug discontinuation in the 150mg bid dabigatran treated cohort. Both seemed to minimize the daily significant cost differential of dabigatran compared to warfarin.